Urban Ecosystems / Ecosystèmes urbains

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    Comparative spatial dynamics of Japanese encephalitis and acute encephalitis syndrome in Nepal
    (PLOS, 2013-07) Robertson, Colin; Pant, Dhan Kumar; Joshi, Durga Datt; Sharma, Minu; Dahal, Meena; Stephen, Craig
    Geographical patterns can provide important clues about disease etiology. Infectious diseases, such as Japanese Encephalitis (JE), are driven by ecological and social processes which result in heterogeneous distribution of disease risk. Pattern indices describing the amount of irrigated land edge density and the degree of landscape mixing for irrigated areas were positively associated with (JE) and acute encephalitis syndrome (AES) risk, while fragmented forest measured by the number of forest patches were negatively associated with AES and JE. These landscape variables highlight the importance of integrating healthy land management policies and disease prevention strategies in both rural and urban-fringe developing areas.
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    Social and environmental determinants of Aedes aegypti infestation in Central Havana : results of a case–control study nested in an integrated dengue surveillance programme in Cuba
    (Blackwell, 2007-04) Spiegel, Jerry M.; Bonet, Mariano; Ibarra, Ana-Maria; Pagliccia, Nino; Ouellette, Veronic; Yassi, Annalee
    objective To characterize the social and environmental risk factors associated with the presence of Aedes aegypti in order to improve community dengue control. methods A case–control study with ‘cases’ being households with entomologically confirmed A. aegypti infestation; personal interviews in Central Havana, a densely populated inner city area characterized by overcrowded housing and irregular water service. The participants were residents of 278 houses with infestation and 556 houses without infestation. results Greater risk of infestation was associated with lack of preventive measures, such as no larvicide in the water tanks (OR ¼ 2.21) and use of flower vases for religious practice (1.93), not being economically active (1.64), vulnerable populations with higher risks in households with older people (1.52) and households with children (1.94). conclusions Efforts to reduce infestations should continue to focus on water tank sanitation and improving housing conditions, but also engage community religious leaders to help promote safe practices. Vulnerable populations should be especially targeted by prevention activities. A surveillance programme can produce evidence to guide interventions.
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    Trans-disciplinary study on the health risks of cryptosporidiosis from dairy systems in Dagoretti, Nairobi, Kenya : study background and farming system characteristics
    (Springer, 2012-08) Kang’ethe, Erastus K.; Kimani, Violet N.; McDermott, Brigid; Grace, Delia; Lang’at, Alfred K.
    This paper characterises the dairy farming system in Dagoretti, Nairobi. Characterisation was part of a broader ecohealth project to estimate the prevalence and risk of cryptosporidiosis and develop risk mitigation strategies. In the project a trans-disciplinary team addressed epidemiological, socioeconomic, environmental and policy aspects of cryptosporidiosis, an emerging zoonosis. This paper also provides background and describes sampling methods for the wider project. Three hundred dairy households were probabilistically sampled from a sampling frame of all dairy households in five of the six locations of Dagoretti, one of the eight districts of Nairobi Province. Randomly selected households identified 100 non-dairy-keeping households who also took part in the study. A household questionnaire was developed, pre-tested and administered in the dry and wet seasons of 2006. An additional study on livelihood and economic benefits of dairying took place with 100 dairy farmers randomly selected from the 300 farms (as well as 40 non-dairy neighbours as a control group), and a risk targeted survey of environmental contamination with Cryptosporidium was conducted with 20 farmers randomly selected from the 29 farmers in the wider survey who were considered at high risk because of farming system. We found that around 1 in 80 urban households kept dairy cattle with an average of three cattle per household. Cross-breeds of exotic and local cattle predominate. Heads of dairykeeping households were significantly less educated than the heads of non-dairy neighbours, had lived in Dagoretti for significantly longer and had significantly larger households. There was a high turnover of 10 % of the cattle population in the 3-month period of the study. Cattle were zero grazed, but productivity parameters were sub-optimal as were hygiene and husbandry practices. In conclusion, dairy keeping is a minor activity in urban Nairobi but important to households involved and their community. Ecohealth approaches are well suited to tackling the complex problem of assessing and managing emerging zoonoses in urban settings.
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    Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya
    (Springer, 2012-08) Kimani, Violet N.; Mitoko, Grace; McDermott, Brigid; Grace, Delia; Ambia, Julie
    The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium fromurban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). Onehundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of nondairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi.
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    Prevalence of cryptosporidiosis in dairy cattle, cattle-keeping families, their non-cattle-keeping neighbours and HIV-positive individuals in Dagoretti Division, Nairobi, Kenya
    (Springer, 2012-08) Kange’the, Erastus; McDermott, Brigid; Grace, Delia; Mbae, Cecilia; Mulinge, Erastus
    This paper reports a study estimating the prevalence of cryptosporidiosis, an emerging zoonosis, in people and cattle in Dagoretti, Nairobi. A repeated cross-sectional survey was carried out among randomly selected cattle keepers in Dagoretti, their dairy cattle and their non-cattle-keeping neighbours in the dry and wet seasons of 2006. A survey was also carried out among a group of people living with human immunodeficiency virus (HIV). Faecal samples were examined for Cryptosporidium oocysts using the modified Ziehl–Neelsen method; 16 % of the samples were also examined using immunofluorescence antibody (IFA) technique. Quality control consisted of blind reviews of slides, examining split samples and confirming slide results with IFA. We found that members of dairy households had a dry season cryptosporidiosis prevalence of 4 % and wet season prevalence of 0.3 %, and non-dairy households, a prevalence of 5 and 0 %, respectively. The cattle dry season prevalence was 15 %, and the wet season prevalence, 11 %. The prevalence in people living with HIV was 5 %. The laboratory quality control system showed some inconsistency within and between different tests, indicating challenges in obtaining consistent results under difficult field and working conditions. In conclusion, this is the first reported study to simultaneously survey livestock, livestock keepers and their neighbours for cryptosporidiosis. We failed to find evidence that zoonotic cryptosporidiosis is important overall in this community. This study also draws attention to the importance of quality control and its reporting in surveys in developing countries.
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    Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi, Kenya
    (Springer, 2012-08) Nyangaga, Julius N.; Grace, Delia; Kimani, Violet; Kiragu, Monica W.; Langat, Alfred K.
    A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change.
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    Multiple burdens of zoonotic disease and an ecohealth approach to their assessment
    (Springer, 2012-08) Grace, Delia; Gilbert, Jeff; Randolph, Thomas; Kang’ethe, Erastus
    Zoonoses occur at the interface of human and animal disease and partly because their impact and management fall across two sectors they are often neglected. The Global Burden of Disease captures the impact of zoonoses on human health in terms of disability-adjusted life years (DALYs). Based on this, we estimate that in low income countries, zoonoses and diseases which recently emerged from animals make up 26 % of the DALYs lost to infectious disease and 10 % of the total DALYs lost. In contrast, in high income countries, zoonoses and diseases recently which emerged from animals represent less than 1 % of DALYs lost to infectious disease and only 0.02 % of the total disease burden. We present a framework that captures the costs of zoonoses and emerging disease to human, animal and ecosystem health in terms of cost of treatment, cost of prevention, health burden and intangible and opportunity costs. We also discuss how ecohealth concepts of transdisciplinarity, participation and equity can help in assessing the importance of zoonoses in developing countries and illustrate these with an example of assessing milk-borne disease.
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    Development and delivery of evidence-based messages to reduce the risk of zoonoses in Nairobi, Kenya
    (Springer, 2012-08) Kang’ethe, Erastus; Kimani, Violet; Grace, Delia; Mitoko, Grace; McDermott, Brigid
    This paper describes a trans-disciplinary process of co-generating and disseminating evidence-based messages for reducing the risk from cryptosporidiosis and other zoonoses in an urban community in Nairobi. Research findings about disease prevalence, risk factors and observed risky and risk-mitigating practices were analysed by a team comprising researchers, community members and local policy- and decision-makers. Using participatory planning, multiple strategies were developed for disseminating key information. We identified five vulnerable groups at higher risk of exposure to cryptosporidiosis and other cattle zoonoses with similar transmission pathways (women, children, elderly people, immunosuppressed people and male farm workers). For each group, targeted messages were developed. Good practices already in use, as were also practices as practices to improve environmental conditions. These messages were disseminated through printed material, in a workshop, through community campaigners and also an edutainment soap opera episode broadcast on Kenyan television. In conclusion, a participatory and trans-disciplinary process can help transform the findings of research into messages that are targeted, attractive and understandable.
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    Evaluating a group-based intervention to improve the safety of meat in Bodija Market, Ibadan, Nigeria
    (Springer, 2012-08) Grace, Delia; Dipeolu, Morenike; Olawoye, Janice; Ojo, Ernest; Odebode, Stella
    We evaluated a group-based, participatory training intervention to improve food safety among meat processors and retailers in Bodija Market, Ibadan, Nigeria. An interactive training workshop was held for Butchers Associations’ representatives who were selected to pass on information and training to their group. Meat hygiene knowledge, attitude and practice was assessed before attending the workshop and afterwards (n063). It was also assessed for those who did not attend the workshop (n068) but were intended recipients of training through their association. Microbiological quality of meat was assessed before and after the workshop (n0400 samples). After the workshop, participants significantly improved knowledge, attitude and practice in key food safety aspects; specifically, understanding sources of contamination and food-borne diseases, use of bleach and disinfectant and hand washing. Participants also shared information with an average of 18 other group members and improvements were seen in group members who did not attend the workshop but received training through their Butchers Association.
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    Cryptosporidium species detected in calves and cattle in Dagoretti, Nairobi, Kenya
    (Springer, 2012-07) Kang’ethe, Erastus K.; Mulinge, Erastus K.; Skilton, Robert A.; Njahira, Moses; Monda, Joseph G.
    A total of 1,734 cattle faecal samples from 296 dairy-keeping households were collected from urban settings in Nairobi, Kenya. Modified Ziehl–Neelsen staining method and an immunofluorescence assay were used to identify those samples with Cryptosporidium oocyst infection. Oocysts from positive faecal samples were isolated by Sheather's sucrose flotation method and picked from the concentrate using cover slips. Genomic DNA was extracted from 124 of the faecal samples that were positive for Cryptosporidium and was used as template for nested PCR of the 18S rRNA gene. Twentyfive samples (20 %) were PCR-positive for Cryptosporidium, and 24 of the PCR products were successfully cloned and sequenced. Sequence and phylogenetic analysis identified 17 samples (68 %) as Cryptosporidium parvum-like, four samples (16 %) as Cryptosporidium ryanae, three samples (12 %) as Cryptosporidium andersoni and one sample (4 %) as Cryptosporidium hominis. To the best of our knowledge, this is the first genotyping study to report C. parvum-like, C. andersoni and C. hominis in cattle from Kenya. The results of this study show Cryptosporidium infections in calves and cattle may be potential zoonotic reservoirs of the parasite that infects humans.
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    Influence of gender and group membership on food safety : the case of meat sellers in Bodija market, Ibadan, Nigeria
    (Springer, 2012-08) Grace, Delia; Olowoye, Janice; Dipeolu, Morenike; Odebode, Stella; Randolph, Thomas
    We describe a study to assess the bacteriological quality and safety of meat in Bodija market in Ibadan and to investigate the influence of gender and group membership on food safety. Mixed methods were used to gather information on meat safety and related socioeconomic factors. These methods included a participatory urban appraisal, focus group discussions with eight butchers’ associations, in depth discussions with six key informants, a questionnaire study of 269 meat sellers and a cross-sectional survey of meat quality (200 samples from ten associations). We found that slaughter, processing and sale of beef meat take place under unhygienic conditions. The activities involve both men and women, with some task differentiation by gender. Meat sold by association members is of unacceptable quality. However, some groups have consistently better quality meat and this is positively correlated with the proportion of women members. Women also have significantly better food safety practice than men, though there was no significant difference in their knowledge of and attitude towards food safety. Most meat sellers (85 %) reported being ill in the last 2 weeks and 47 % reported experiencing gastrointestinal illness. Eating beef, eating chicken, eating offal, consuming one’s own products and belonging to a group with poor quality of meat were all strong and significant predictors of self-reported gastrointestinal illness.We include that gender and group membership influence meat quality and self reported gastrointestinal illness and that butchers’ associations are promising entry points for interventions to improve food safety.
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    Participatory and integrative approaches to food safety in developing country cities
    (Springer, 2012-08) Grace, Delia; Kang’ethe, Erastus; Waltner-Toews, David
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    Participatory probabilistic assessment of the risk to human health associated with cryptosporidiosis from urban dairying in Dagoretti, Nairobi, Kenya
    (Springer, 2012-08) Grace, Delia; Monda, Joseph; Karanja, Nancy; Randolph, Thomas F.; Kang’ethe, Erastus K.
    We carried out a participatory risk assessment to estimate the risk (negative consequences and their likelihood) from zoonotic Cryptosporidium originating in dairy farms in urban Dagoretti, Nairobi to dairy farm households and their neighbours.We selected 20 households at high risk for Cryptosporidium from a larger sample of 300 dairy households in Dagoretti based on risk factors present. We then conducted a participatory mapping of the flow of the hazard from its origin (cattle) to human potential victims. This showed three main exposure pathways (food and water borne, occupational and recreational). This was used to develop a fault tree model which we parameterised using information from the study and literature. A stochastic simulation was used to estimate the probability of exposure to zoonotic cryptosporidiosis originating from urban dairying. Around 6 % of environmental samples were positive for Cryptosporidium. Probability of exposure to Cryptosporidium from dairy cattle ranged from 0.0055 for people with clinical acquired immunodeficiency syndrome in non-dairy households to 0.0102 for children under 5 years from dairy households. Most of the estimated health burden was born by children. Although dairy cattle are the source of Cryptosporidium, the model suggests consumption of vegetables is a greater source of risk than consumption of milk. In conclusion, by combining participatory methods with quantitative microbial risk assessment, we were able to rapidly, and with appropriate ‘imprecision’, investigate health risk to communities from Cryptosporidium and identify the most vulnerable groups and the most risky practices.
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    Return to Kathmandu - A Post Hoc Application of AMESH
    (2008) Neudoerffer, R Cynthia; Waltner-Toews, David; Kay, James J
    This chapter provides background to the development of the adaptive methodology for ecosystem sustainability and health (AMESH). AMESH approaches seemed to parallel ecological, economic, demographic, and social developments in Nepal. AMESH is characterized by: (1) Documenting the presenting situation; (2) Analysis of stakeholders, issues, policy, politics and governance; (3) People and their stories; (4) Systems descriptions and narratives; and (5) Collaborative learning and action. Descriptions include details of case studies derived from various stakeholder groups. Often community development work requires sanctioning by local leaders, who can act as entry points between researchers and the community.
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    Rostros del reciclaje : una experiencia de investigación con enfoque ecosalud en Lima - Perú
    (Consorcio por la Salud, Ambiente y Desarrollo (ECOSAD), 2011) Márquez Quispe, Carlos Jesús; Vallejos Dávalos, Julio
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    EcoHealth : a primer
    (Veterinarians without Borders/ Vétérinaires sans Frontières, CA, 2011) Waltner-Toews, David
    The primer is an introduction to key ideas and practices in an “ecosystem approach to health” or ecohealth. The major tools for doing ecohealth are questions rather than techniques per se (see chapter 5). The techniques for how those questions are asked will vary from situation to situation, from geospatial mapping to interviews, from workshops to mathematical modeling. The combination of stakeholder participation – which necessarily leads to multiple perspectives on reality, and systems thinking – which necessarily leads to questions of relationships, boundaries and responsibilities, takes us to the core of the ecohealth approach, which is complexity.
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    Proceedings of the IDRC-organised panels at the 8th International Conference on Urban Health, ICUH 2009, Nairobi, Kenya, October 18 - 23, 2009
    (IDRC, 2010) IDRC
    Workshop papers focus on waste management in informal settlements and urban slum conditions. Neglect by local leaders/government is key to an ongoing poorly functioning system. Urban authorities continue to leave beneficiary communities as ‘passive’ service consumers. To improve the urban environment and health status of the urban poor, affected communities should be involved in problem identification and proposed solutions. Unsafe water, poor drainage and garbage disposal, inadequate latrines and air pollution are key urban environmental problems.
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    Kathmandu urban ecosystem health project a model approach
    (2009) Joshi, D.D.; Sharma, Minu
    International Development Research Centre (IDRC) supported research study on Echinococcosis/Hydatidosis which was carried out between 1992 and 2001 in Kathmandu Metropolitan City Nepal. The research work was carried out in two distinct project stages in wards 19 and 20 of KMC one from 1992-1996(applying a traditional epidemiology approach) and a second was Urban Ecosystem Health Project (UEHP) Approach from 1998-2006. Overall, there were three main step of activities in the development of the UEHP in Nepal: First is an exploratory/analytical systemic steps focusing on linkages between social, ecological, and health variables (1998-2001); The second a community action step employing a variety of systemic, narrative, and participatory-action research tools (2003-2006); and the third phase of urban ecosystem health project started from 2007 to 2009 which is now running. Community participation or participatory action research is a key element of ecosystem health programmes. Participatory Action Research approaches have three main goals. The first step is to describe what is there? What are the physical and socio-economic possibilities of this person or place? If we use the analogy of a person. The Second step, for ecosystems as for individuals, health is not just a physical state, but what we might call a spiritual state. It has been said that in any part of the world no solutions will be sustainable in the long run unless they are rooted in the communities where the problems occur, drawing on the people in these communities and their many skills, resources, and important knowledge, and those communities feel empowered and supported by higher levels of government. If such approaches can be worked out between local communities in Indian Subcontinent, non-government organizations, businesses, regional institutions of government and university, and with outside input only as necessary, then truly sustainable solutions will be found, and Kathmandu.
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    Diagrammatic approach to understanding complex eco-social interactions in Kathmandu, Nepal
    (Resilience Alliance, 2005) Neudoerffer, R. Cynthia; Waltner-Toews, David; Kay, James J.; Joshi, D. D.; Tamang, Mukta S.
    As part of developing an international network of community-based ecosystem approaches to health, a project was undertaken in a densely populated and socio-economically diverse area of Kathmandu, Nepal. Drawing on hundreds of pages of narrative reports based on surveys, interviews, secondary data, and focus groups by trained Nepalese facilitators, the authors created systemic depictions of relationships between multiple stakeholder groups, ecosystem health, and human health. These were then combined to examine interactions among stakeholders, activities, concerns, perceived needs, and resource states (ecosystem health indicators). These qualitative models have provided useful heuristics for both community members and research scholars to understand the eco-social systems in which they live; many of the strategies developed by the communities and researchers to improve health intuitively drew on this systemic understanding. The diagrams enabled researchers and community participants to explicitly examine relationships and conflicts related to health and environmental issues in their community.
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    Three years progress report on Urban Ecosystem Health Project phase - II, 14 October 2003 – 13 October 2006
    (National Zoonoses and Food Hygiene Research Centre (NZFHRC), Kathmandu, NP, 2006) Joshi, D.D.